6. Thinking blocks / decision making problems in ADHD

• 6.1. Thinking blocks as an ADHD symptom
• 6.2. Decision-making problems as an ADHD symptom
• 6.3. Neurophysiological correlates of thinking blocks and decision making problems
• 6.4. Thought blocks as symptoms of stress

6.1. Thinking blocks as an ADHD symptom¶

Thinking blocks are a phasic impairment of cognitive performance, usually caused by a large acute stress load.

A typical example of thinking blocks are exam blackouts.
Thinking blocks occur with about equal frequency in ADHD-HI as in ADHD-I.

6.2. Decision-making problems as an ADHD symptom¶

Decision-making problems means problems with making decisions, not problems with the quality or correctness of decisions made.

Decision-making problems seem to be significantly more frequent in ADHD-I than in ADHD. This suggests that the different manifestations have different neurophysiological correlates.

While ADHD-HI correlates more strongly with decision-making that is too spontaneous, too impulsive, in ADHD-I the ability to make a decision is often massively impaired. Even simple decisions can trigger the feeling of being overwhelmed.

6.3. Neurophysiological correlates of thinking blocks and decision making problems¶

High levels of norepinephrine block the PFC via alpha-1 adrenoceptors and shift behavioral control to posterior brain regions.²³⁴⁵ Since the PFC is very important for weighing multiple decision options, blockade of the PFC naturally leads to increased decision-making problems.
Decision-making problems are to be distinguished from difficulties of time perception.⁶

For more details, see ⇒ Neurophysiological correlates of thinking blocks and decision problems

6.4. Thought blocks as symptoms of stress¶

Thought blocks are also known to be symptoms of severe stress.⁷⁸